DELIA E ACUNA
NPI 1679008973, individual, Chester, VA, Nurse Practitioner, Adult Health
- Hours beyond a day in 2 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99309 ($122 per patient-month) sit in the top 5% of every provider billing that code.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2021 | More hours than a day holds at a conservative unit price | 15.9 | 36.3 | 24.2 | 35.7 | 171 | 1 | 99309 99310 | $27K |
| Jan 2024 | More hours than a day holds at a conservative unit price | 13.6 | 42.0 | 28.0 | 37.7 | 146 | 1 | 99309 99310 | $37K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | DELIA E ACUNA |
| Type | Individual |
| Status | Active |
| NPI issued | April 24, 2017, last updated April 21, 2026 |
| Practice location | 4313 OLD HUNDRED RD, Chester, VA 23831-4232, 757-340-3489 |
| Specialties | Nurse Practitioner, Family (363LF0000X, license 0024174726 VA) Nurse Practitioner, Adult Health (363LA2200X, primary, license 0024174726 VA) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $1.2M | 91% | $122 | $21 (top 5% from $84) | 98th percentile | |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $91K | 7% | $51 | $30 (top 5% from $134) | 73rd percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $21K | 2% | $32 | $14 (top 5% from $58) | 85th percentile | |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | $3K | 0% | $13 | $7.86 (top 5% from $34) | 74th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 4,322 | 256 | $294K | $165 | $88 | 1.9x | 2.0x (90th percentile 3.3x) |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 308 | 15 | $25K | $235 | $104 | 2.3x | 2.0x (90th percentile 3.4x) |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 141 | 111 | $13K | $240 | $126 | 1.9x | 2.0x (90th percentile 3.4x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
15 providers in Chesterfield County, VA carry an indicator in the public record, with $12.3M at stake between them. The most common is more hours than a day holds, on 8 of them, followed by part of a provider network on 4.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | THE ITHIEL GROUP, LLC Richmond, VA, ranked 1069 | $852K |
|
| 3 | JAMES RIVER HOME HEALTH CARE, LLC North Chesterfield, VA, ranked 1474 | $26K |
|
| 3 | TRINITY HOSPICE 2, LLC Richmond, VA, ranked 1658 | $1K |
|
| 3 | INTEGRITY HOME HEALTH INC Richmond, VA, ranked 1695 | $254 |
|
| 3 | JAMES RIVER HOME HEALTH CARE, LLC North Chesterfield, VA, ranked 4368 | $0 |
|
| 4 | CYNTHIA FREY Colonial Heights, VA, ranked 7993 | $308K |
|
| 4 | DETRINA CRAWLEY North Chesterfield, VA, ranked 8413 | $4.9M |
|
| 4 | JAGDEEP KAHLON Midlothian, VA, ranked 8568 | $2.9M |
|
Recent enforcement in VA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.